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Concerns in the Management of Heart Failure: Staying on the Path to Optimal Medical Therapy

Concerns in the Management of Heart Failure: Staying on the Path to Optimal Medical Therapy



Time to Complete

150 minutes


June 1, 2018


July 31, 2020
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Certification Update

Reviewed and recertified until July 31, 2020.

Maximum Credits

2.50 / AMA PRA Category 1 CreditTM
2.50 / CNE Contact Hour

Accredited Provider

Provided by the American College of Cardiology Foundation in collaboration with Haymarket Medical Education

Commercial Supporter

Supported by an educational grant from Novartis Pharmaceuticals Corporation

Program Description

The complexity of care management for patients with chronic heart failure (HF) can be overwhelming for clinicians, care teams, the patients and their caregivers. From the need for aggressive risk stratification through guideline-directed disease management (including end-of-life shared decision-making), it is difficult to streamline strategies and ensure personalized treatment plans in patients who often have multiple comorbidities such as hypertension, diabetes, coronary disease, and frailty—as well as conditions such as depression and cognitive and/or sensory deficits, lack of social support, and disability. Adding to the complexity is rapid dissemination of scientific findings, the introduction of new therapies, and the need to stay informed about updated guidelines for HF patients. In this educational activity, two HF experts provide practice guidance about addressing these common clinical challenges.

Intended Audience

This activity is intended for cardiologists, internists, primary care physicians, nurses, nurse practitioners (NPs), physician assistants (PAs), and other clinicians who manage patients with chronic heart failure.

Educational Objectives

At the conclusion of this activity, participants should be better able to:

  • Implement guideline-directed medical strategies, including dose titration and optimization of pharmacotherapy in patients with chronic heart failure (HF)
  • Recognize patients who would benefit from referral to specialist care, including HF centers and/or hospice care
  • Counsel patients and their caregivers about optimal strategies to manage their HF and associated comorbid conditions

Accredited Provider Disclosure of Conflicts of Interest Statement and Disclosure Policy

As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME) and the American Nurses Credentialing Center (ANCC), the American College of Cardiology Foundation (ACCF) must ensure balance, independence, objectivity, and scientific rigor in all of its directly provided or jointly provided/co-provided educational activities. Planners, presenters, and other contributors in a position to control the content are required to disclose to the audience all relevant financial relationships he/she and/or his/her spouse or domestic partner may have, occurring within the past 12 months, with any entity producing, marketing, reselling, or distributing healthcare goods or services consumed by, or used on, patients. When an unlabeled use of a commercial product or an investigational use not yet approved for any purpose is discussed during an educational activity, the contributor should disclose that the product is not labeled for the use under discussion or that the product is still investigational.

ACCF is committed to providing its learners with high-quality activities and materials that promote improvements and quality in healthcare and not a specific proprietary business or commercial interest. The intent of this disclosure is not to prevent participation in certified educational activities by persons with a financial or other relationship, but rather to provide learners with information on which they can make their own determination whether financial interests or relationships may influence the certified activity.

ACCF assesses conflict of interest (COI) with its faculty, planners, managers, staff, and other individuals who are in a position to control the content of certified CME/CNE activities. All relevant potential conflicts of interest that are identified are thoroughly vetted by course directors, ACCF education staff, and members of the Accreditation Compliance Workgroup through a process that includes appropriate peer review for fair balance, scientific objectivity and validity, and patient care and safety recommendations.



Alison L. Bailey, MD, FACC, FAACVPR

Program Director, Cardiovascular Diseases Fellowship
Director, Preventive Cardiology and Cardiac Rehabilitation
Erlanger Heart and Lung Institute, University of Tennessee College of Medicine
Chattanooga, TN

Alison Bailey, MD, FACC, FAACVPR, was the lead investigator for clinical trials that received funding from Theracos, Inc., and ZOLL.

Tina Shah, MBBS, FACC
Assistant Professor of Medicine
Baylor College of Medicine
Michael E. DeBakey VA Medical Center, Section of Cardiology
Houston, TX

Tina Shah, MBBS, FACC, has no relevant financial relationships to disclose.


Margaret Bowers, DNP, RN, FNP-BC, CHFN, AACC, FAANP

Associate Professor
Faculty Coordinator, Adult Nurse Practitioner Programs
Lead Faculty, Cardiovascular Specialty
Duke University School of Nursing
Durham, NC

Margaret Bowers, DNP, RN, FNP-BC, CHFN, AACC, FAANP, has received speakers' bureau fees from Amgen.

Akshay Desai, MD, MPH, FACC
Director, Heart Failure Disease Management
Cardiovascular Division
Brigham and Women’s Hospital
Associate Professor of Medicine
Harvard Medical School
Boston, MA

Akshay Desai, MD, MPH, FACC, reports receiving research grants from Novartis and consulting fees from AstraZeneca, Cheetah Medical, Janssen, Merck, Novartis, Relypsa, Sanofi, and St. Jude Medical.

Alan Wasserman, MD, MACP, FACC
Chairman, Department of Medicine
Eugene Meyer Professor of Medicine
George Washington School of Medicine and Health Sciences
George Washington University Medical Center
Washington, DC

Alan Wasserman, MD, MACP, FACC, has no relevant financial relationships to disclose.

Cathleen Biga, RN, MSN
President and CEO
Cardiovascular Management of Illinois
Woodridge, IL

Cathleen Biga, RN, MSN, has no relevant financial relationships to disclose.

Kimberly V. Cheramie, MSN, RN-BC
Nurse Planner
American College of Cardiology
Washington, DC

Kimberly V. Cheramie, MSN, RN-BC, has no relevant financial relationships to disclose.

Accredited Provider Disclosures

ACCF staff involved in this activity have no relevant financial relationships to disclose.

Haymarket Medical Education staff involved in this activity have no relevant financial relationships to disclose.




AMA PRA Category 1 Credit(s)TM

Accreditation Statement

The American College of Cardiology Foundation (ACCF) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement

The ACCF designates this enduring material for a maximum of 2.50 AMA PRA Category 1 CreditsTM .  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physician Assistants
The American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities certified for AMA PRA Category 1 CreditTM   from organizations accredited by ACCME.




CNE Contact Hour(s)

Accreditation Statement

The American College of Cardiology Foundation is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Designation Statement

The ACCF designates this educational activity for a maximum of 2.50 continuing nursing education contact hours.

While offering credits noted above, the module is not intended to provide extensive training or certification in the field.

Disclosure of Unlabeled Use

This CME activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CME activity is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options for a specific patient’s medical condition.


The American College of Cardiology Foundation (ACCF) is not responsible for statements made by any contributor. Statements or opinions expressed in this program reflect the views of the contributors and do not reflect the official policy of the ACCF.


This activity is offered at no cost to participants. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the post-test and evaluation, and have received a digital copy of your credit certificate. Your online certificate will be saved on myCME within your Profile/CME History, which you can access at any time.

If you have an American College of Cardiology (ACC) account, you can choose to have your credit information sent to your ACC Transcript upon completion of the course. You will be prompted to log in to your ACC account, which will automatically trigger your credit submission. If you do not have an ACC account, you will have the opportunity to create one.

ACCF Learner Bill of Rights

The ACCF recognizes that you are a lifelong learner who has chosen to engage in continuing medical education to identify or fill a gap in knowledge or skill and to attain or enhance a desired competency. As a participant in an ACCF activity, you have the right to expect that your continuing medical education experience with ACCF includes the following.

Content that:

  • Promotes improvements or quality in healthcare
  • Is current, valid, reliable, accurate, and evidence-based
  • Addresses the stated objectives or purpose
  • Is driven and based on an independent survey and analysis of learner needs, not commercial interests
  • Has been reviewed for bias and scientific rigor
  • Offers balanced presentations that are free of commercial bias
  • Is vetted through a process that resolves any conflicts of interest of planners and faculty
  • Is evaluated for its effectiveness in meeting the identified educational need

A learning environment that:

  • Is based on adult learning principles that support the use of various modalities
  • Supports learners’ abilities to meet their individual needs
  • Respects and attends to any special needs of the learners
  • Respects the diversity of groups of learners
  • Is free of promotional, commercial, and/or sales activities

Disclosure of:

  • Relevant financial relationships that planners, teachers, and authors have with commercial interests related to the content of the activity
  • Commercial support (funding or in-kind resources) of this activity


Hardware and Software Requirements
  • A computer with an internet connection
  • Internet Browser: Internet Explorer 7.x or higher, Firefox 4.x or higher, Safari 2.x or higher, or any other W3C standards compliant browser
  • Additional Software: Adobe Flash Player and/or an HTML 5 capable browser maybe required for video or audio playback. PowerPoint or Adobe Acrobat Reader may occasionally be required
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